Aging is a normal part of life, which affects every major organ in the body. It is not a disease; it is a normal developmental process. While the aging process is normal, it is important to understand its effects on the body in order to maintain an active and healthy lifestyle. It is additionally important to remember that everyone is different and many factors influence aging. These can include family history, lifestyle, diet, disease, environment, coping behaviors, emotional health and social support.
The aging process has multiple effects on the musculoskeletal system. The balance between bone reabsorption and the building of new bone changes, which results in an overall loss of, bone mass. Bones lose calcium and mineral density and the resulting, more brittle bone, becomes susceptible to fracture. Cartilage thins and loses water content and ligaments, which connect bones together, become less elastic and lose flexibility.
As we age, there is also a loss of overall muscle mass. The number and size of muscle fibers decreases and results in slower muscle activation. Additionally, the tendons that connect muscle to bone lose water content and are consequently less able to handle load and stress. In the spine, discs lose fluid content and become thin, which in combination with the thinning of vertebral bones, is a part of why we lose height with advancing age. This loss of flexibility in the tendons, ligaments, and soft tissues, combined with the age related degeneration of cartilage results in an overall decrease in joint mobility.
Equally important are the changes in balance, with many causes of being traced to a decrease in the sensation of touch, and a loss of proprioception. Proprioception is the sense that allows us to know where our body is in space, and a decrease can result in increased risk of fall and changes in the gait pattern. Arm-swing decreases in the walking cycle as we age, contributing to an unsteady walking pattern.
While the changes associated with aging are numerous, the important thing to remember is that they are a normal, everyday part of living. Normal aging is a stage in the normal maturation process. What is not normal is when outside factors such as disease or prior trauma influence the aging process. When this happens it is described as pathological aging and we will further discuss pathological aging in our next blog.
While it can be daunting to look at the numerous effects aging has on the body it is important to remember that you have the ability to prevent problems before they occur. Exercise is one of the best ways to prevent injury and slow the degenerative process. Anyone can exercise with the right individualized prescription, and the benefits of exercise have been well documented by numerous studies.
Resistance training has been show to slow and reverse muscle loss. It increases strength and power, which has a direct effect on the activities we do throughout the day. Additionally, performing strength training is associated with increasing bone mineral density and slowing the loss of bone mineral density that increases with age. An important consideration when looking at resistance training is the need for bone loading and weight bearing in order to achieve these gains. While there are many benefits to non-weight bearing and pool exercises, it is important to perform weight-bearing exercise for bone and joint health. Lastly, it is important to make sure the dose of exercise is appropriate, just as you take the right amount of medication, which includes the amount of weight, resistance, and repetitions for each exercise. A recent document released by the American Physical Therapy Association (APTA) stated that resistance exercise is often prescribed to older adults at a dose too low to provide benefits. An accurate strength-training plan needs to be tailored to an individual in order to provide health benefits.
Improving posture can also have a major effect on an individual’s function. As we age we tend to gravitate towards a slumped posture. In this position the body cannot function to its best ability, nothing is where it’s supposed to be and spending too much time in this type of posture can increase pain. In order to maintain good posture you have to be able to stay in good posture and core work for the neck and back is an important piece. By improving the stability of the spine it is not only easier to stay in a good biomechanical position, but also to prevent and improve back and neck pain.
Balance training is another important consideration when looking at developing an exercise program. Exercise will typically begin simply with safety being the primary concern and eventually progressing to more difficult, dynamic balance activities. Balance affects every part of our lives, from walking and standing, to reaching and carrying objects and everything in between. Most importantly, as we age our risk of fall increases, and working to improve balance can reduce this risk and less risk of fall correlates to a reduced risk of fracture.
Regardless of where an individual is in the realm of normal and pathological aging, physical therapy and exercise can be of tremendous benefit in not only treating, but also preventing injury. Aging is a normal part of life, and at Life’s Work Physical Therapy (LWPT) our goal is for our clients to continue living active lifestyles while maintaining a healthy musculoskeletal system. If you have any questions about exercise or the effects of aging on the body, please feel free to call Life’s Work Physical Therapy to set up an appointment.